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Crown Lengthening (Clinical) #14 by Solea Laser

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Crown Lengthening (Clinical) #14 performed by Timothy Anderson, DDS

 This case highlights Solea’s exceptionally clean and precise cutting of soft and osseous tissue that enhances the CEREC’s same day dentistry workflow. 

Case Summary: A 62-year-old male patient presented to the practice with very deep decay to the level of the alveolar crest. Tooth #14 required clinical crown lengthening to restore with a crown. With Solea, performing the surgery and placing the definitive restoration on the same day was possible.

Technique Used: To start, the existing amalgam was removed with a carbide bur. Caries was then removed utilizing Solea. A full coverage crown preparation was completed using Meisinger CEREC Doctors prep kit and an electric handpiece, and some minor troughing was performed to expose margins for a final scan without the need for retraction cord. An Emax crown was designed utilizing the CEREC 4.6 Chairside software and fabricated. Crown lengthening was performed during milling and glazing. A minimally invasive flap was reflected with a periosteal elevator. There was minimal tooth structure coronal to osseous crest on the distal and distal-lingual surfaces. Solea was used to remove and sculpt osseous tissue until there was 2 mm of tooth structure coronal to the bone. Positive bony architecture was maintained. Solea provides unsurpassed precision and clear visualization allowing removal of bone without iatrogenic damage. The final restoration was inserted with SpeedCem Plus self-adhesive resin cement. A single 4-0 chromic gut suture was placed.

Solea Advantage:

  • Solea’s remarkable precision and improved visualization allowed for removal of osseous tissue without iatrogenic damage.
  • Solea enabled complete control of soft and osseous tissue resulting in a very fast and minimally invasive surgical procedure (completed in under 10 minutes with only minimal bleeding).
  • The Solea and CEREC combination allowed the dentist to finish the entire treatment, crown lengthening and the crown itself in the same visit – a true “crown in a day”.
  • The dentist was able to perform this procedure in-house rather than refer it out.
  • The patient was thrilled not only with the esthetic outcome but the speed, comfort, and efficiency, at which the treatment was completed in one visit.

that's amazing Katherine


For those of us that accept insurance... you cannot bill it out the same day and get paid for the crown lenthening. This absolutely sucks


I think making a blanket statement that someone can't do something because they take insurance should be made carefully.  I do crown lengthening and bill out the crown the same day and have never had it rejected.  

Brian


Curious. Was the entire procedure also anesthesia free?
Or branch question. Can you use solea to cut (gingival) tissue without anesthetic?


Brian, I never said you can’t do the procedure. I give away a ton of these procedures. I am saying that in my experience with the insurance companies I deal with... none of them have paid for same day CL when done with the crown prep. I have also been advised by the laser company and their periodontists also that this is the case. That’s what I’m saying.


On 11/14/2019 at 4:06 pm, Todd Greeson said... For those of us that accept insurance... you cannot bill it out the same day and get paid for the crown lenthening. This absolutely sucks

I added the emphasis but I DO take insurance and bill out a crown lengthening and crown at the same time AND get paid for it, by the insurance.  I wouldn't say it is standard operating procedure but it does happen.

Brian


I’d love to know which insurances. I’ll let Biolase know which ones work for you. That way they can be giving out proper information.


This can also be done with the ErYAG lasers.  I have done this with the Waterlase and the Lightwalker.  The Lightwalker is now becoming obsolete as Fotona has rolled out a new hard tissue laser.  I find it curious that cerecdoctors.com is promoting this particular laser by making this a blog thread.  I can only credit the Solea people for being far better at marketing than Fotona.  


I'll see if I can pull up an old case and get the details.

Brian


I have been corrected.  The new Fotona laser is a low output endodontic laser.  The Lightwalker is not being replaced.


I have the Solea and use it daily along with the Periolase laser. I just purchased the Lightwalker Er:YAG and Nd:YAG Combo laser at DS in Las Vegas. I am anxious to work with it clinically and compare.


I do these very often with deeply carious crown procedures.
Benson This is usually done with numbing as patient is already numb for crown 

Crown lengthening, frenectomy, gingivectomy, implant uncovery without any profiling kit, shaping pontic area for bridge are a few very useful applications of Solea besides fillings. Solea get used everyday at my office for one thing or another. For soft tissue you not have either a topical or LA but I don’t really numb at all for fillings. But I chose carefully who I wanna do the fillings on with this. So I don’t set myself up for faliure. Just like cerec and CT this is also one of the most useful investment I made, no regrets.


On 11/18/2019 at 9:08 pm, Steven Price said... I have the Solea and use it daily along with the Periolase laser. I just purchased the Lightwalker Er:YAG and Nd:YAG Combo laser at DS in Las Vegas. I am anxious to work with it clinically and compare.

Wow you have more than $300,000 worth of lasers in your office.  I'm sure Solea is fantastic.  What I like about Lightwalker is the ability to thoroughly cleanse the canal system during RCT.  There is almost no post op pain and all my patients report great after feeling.  Here is the result of RCT on #19 I did 2 weeks ago.  Pt had buccal abscess and discomfort on chewing.  After the RCT, pt stated that he could chew again.

In 2 weeks, the buccal abscess shrunk to nothing and I was able to replace the crown.  Look at the Cerec copy of #19 before RCT and today.

You can also do Photobiomodulation with Nd:Yag which is a great adjunct to any lengthy procedure to relieve patient discomfort.